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Prostate cancer tests are now OK with panel, with caveats

Men ages 55-69 should decide individually with their doctors whether to undergo PSA (prostate-specific antigen) testing for prostate cancer. The health providers still have been approving the breast-cancer imaging procedure for women as young as 40. That is, there is moderate certainty of the test reducing the chance of men dying of prostate cancer, but many men will experience potential harms simply from the screening. These recommendations apply to male adults who have not been previously diagnosed with prostate cancer and have no signs or symptoms of the disease, and to male adults with average or increased risk for prostate cancer (eg, African-American, family history of prostate cancer).

For these men, the task force recommends withholding treatment and monitoring the cancer until it requires treatment.

The cancer-screening pendulum has been swinging back and forth over the years.

Darrell Sabbs, legislative affairs and community benefit manager for Phoebe Putney Health Systems suggested that, community outreach programs that serve high-risk groups should assist communication between members and clinicians, as in most cases these groups neither access the healthcare system nor have a talk with healthcare providers about PSA examination.

Committed to encouraging men to take a more proactive role in protecting their health, PCEC has coordinated hundreds of sites across the country to offer free or low cost prostate health assessments during Prostate Cancer Awareness Week and year round.

Broad-based screening has been criticized for catching tumors that may never pose a serious threat.

We do think that every man deserves to really understand what the science is telling them. The rub, then, is finding a way to catch potentially serious cases early while not overreacting to minor findings. The task force is now taking public comment on the new recommendations. "With this update we have new evidence and our assessment of the balance shifted to now say there is likely a small net benefit to screening".

WILLIAM BRANGHAM: So, let's just say I'm one of these men, I get the test, and the PSA test indicates that I have cancer. And positive biopsies lead to treatment, which can have side effects.

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But while some groups still recommend regular PSA tests, many have tempered their views.

There's no changes to the recommendations for older guys: The task force still recommends against PSA screening for men 70 and older. He said he also doubts harried primary-care doctors will have time to guide patients through complicated discussions on PSA testing, given the importance of talking about other issues like diet, exercise and colonoscopies.

"It's hard to judge". It added that many other factors, including better treatment, probably contributed to the decrease in prostate cancer deaths. Ultimately the health panel claims that men between the ages of 55 to 69 should talk to their physician about the advantages and disadvantages of the PSA test.

And if someone has a slow-growing prostate cancer that doesn't necessarily need treatment, the emotional distress of a cancer diagnosis shouldn't be underestimated, Turini said.

"While it makes theoretical sense that screening may be beneficial for them, there is not enough evidence to suggest that detecting their cancer early will, in the end, make a difference", Trinh said. And one or two would be kept from dying of prostate cancer over a 10- to 15-year period. For men with a baseline PSA greater than 1.5ng/ml they should be monitored and evaluated by an Urologist.

There are other men who might say, the likelihood of benefiting from screening is so small. Their advice influences both physicians and insurance coverage (both public and private insurance)-as the Affordable Care Act covers preventive screenings rated as A or B. A comprehensive review of many breast cancer studies by the National Cancer Institute concluded that "screening for breast cancer does not affect overall mortality". "Today, there is increased evidence that screening well-selected patients saves lives".

The task force is an independent, volunteer panel of experts in prevention and evidence-based medicine that makes recommendations about preventive medical services, such as screenings, counseling services, and preventive medications. Because of this reason, many false-positive results could alarm patients unnecessarily, said Dr. Otis Brawley, chief medical officer of the American Cancer Society. Instead, they should discuss the uncertainties about the test and order it only if their patients still want it, the panel said. Slightly more - 30.5 percent - said they had no discussion about these issues.